During the spread of the SARS-CoV-2 virus, one of the major challenges of epidemiological surveillance was to obtain up-to-date and comprehensive data on people with COVID-19 in social and medical-social care facilities (ESMS). This article describes the implementation of the COVID-19 surveillance system in ESMS (SurvESMS) and its adaptation to meet the needs of surveillance stakeholders and decision-makers, as well as to evolving practices in light of the gradual accumulation of knowledge about COVID-19. The development of this surveillance system highlights the need for high-performance, agile IT platforms that provide access to residents’ health data and enable the rapid development of surveillance systems in emergency situations.